Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

“This is completely pointless,” the 24-year-old Chicagoan said of the warning telling him that, while condoms can help prevent the spread of some sexually transmitted diseases, there are no guarantees.

Even so, that tiny bit of print is at the center of a raging debate now that President Bush has asked the Food and Drug Administration to modify the current warning to include information about human papillomavirus, commonly called HPV or genital warts.

On one side are scientists who believe that condoms should be promoted as a crucial line of defense against several STDs and cervical cancer. On the other are groups that advocate waiting for sex until marriage, and who see the dangers of HPV as an argument for their cause.

“The lack of information getting to the American public regarding this disease is beyond comprehension,” said Linda Klepacki, manager of the abstinence policy department at Focus on the Family, a Colorado-based organization.

She and others point to research showing that condoms don’t necessarily prevent the spread of HPV, in part because it may be found on parts of the body the latex devices don’t cover. Abstinence is the best way to prevent the disease, she argues.

Adding that information to a condom label would be “truth in advertising,” said Libby Gray. She’s the director of Project Reality, an Illinois-based group that teaches public school students about abstinence — and notes that most students she speaks with have no idea what HPV is.

Dismissing important information?But scientists who study HPV worry that abstinence groups are dismissing important information to promote their own values.

“I want to be polite. But it appalls me when I see scientific and medical studies being manipulated for a different agenda,” said Tom Broker. He’s a professor of biochemistry and molecular genetics at the University of Alabama at Birmingham and president of the International Papillomavirus Society, a coalition of experts who study HPV.

The focus, Broker said, should be on the fact that condoms have been shown to reduce the risk of cervical cancer, which is caused by HPV and which can be detected and treated if women get regular PAP smears. (The federal Centers for Disease Control issued a recent report to Congress that included the same conclusion.)

Broker also said research has shown that HPV transmission is less likely when a person does not have other STDs, such as HIV, gonorrhea and chlamydia, which condoms have been shown to combat.

Both he and Dr. Ward Cates, former head of the CDC’s STD/HIV prevention group, agreed that teaching abstinence is a key to preventing the spread of disease.

But when someone becomes sexually active, they also believe that “condoms are the best imperfect way we have,” said Cates, now president of the family Health Institute of Family Health International, nonprofit global health organization based in North Carolina.

Fretting over the fine printOfficials at the FDA concede that boiling down a “very extensive and complicated” body of scientific literature on HPV and into a few words on a condom label is no easy task.

“It must be medically accurate and at the same time, be clear and understandable for, like, my 17-year-old when he goes out on Saturday night,” said Dr. Dan Schultz, director of the FDA’s Office of Device Evaluation. He expects to issue recommendations on an HPV warning by the end of the year.

Some young people, meanwhile, are frustrated that so much attention is being paid to wording on a condom label.

“Honestly, getting people to use a protection at all is the biggest step,” said Jessica Keefe, a 21-year-old senior at the University of Michigan. “I know so many smart, well-educated college students who don’t use them — even after years of sex ed and university health programs.”

Marina Elbert, a 20-year-old junior at Rutgers University, said she’s among those who’d be unlikely to read or heed a condom package label.

“I’m a smoker, and I read the warning labels on my cigarettes, but I still smoke,” she said. “That’s the same mentality that teens might have toward condom labels.”

She’d rather get information from her doctor or books, magazines and Web sites. To that end, the makers of such condom brands as Trojan and Durex have posted information on their Web sites about STDs, as has retailer Condomania.com.

Kleinman, the 24-year-old Chicagoan, agrees that’s a better tactic than labeling: “If the money can teach one kid in school the dangers of sex — even with a condom — then it will have been put to a lot more good than any fine-print label on a crumpled wrapper on the bed stand.”